Non Invasive ImagingNon Invasive Imaging A1050 JACC April 1, 2014 Volume 63, Issue 12 coronary...
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Non Invasive Imaging A1050 JACC April 1, 2014 Volume 63, Issue 12 CORONARY ARTERY CALCIUM SCORE OF <100 EFFECTIVELY RULES OUT PRESENCE OF SIGNIFICANT ISCHEMIA, WHILE >=400 RULES IN-INSIGHT FROM A META-ANALYSIS OF 14 STUDIES Poster Contributions Hall C Saturday, March 29, 2014, 10:00 a.m.-10:45 a.m. Session Title: Coronary and Cardiac CT: Improving Diagnoses Abstract Category: 18. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT Angiography Presentation Number: 1104-63 Authors: Chirag Bavishi, Saurav Chatterjee, Edgar Argulian, Taimur Mirza, Alan Rozanski, St. Luke’s-Roosevelt Hospital Center, New York, USA Background: Single photon emission myocardial perfusion imaging (SPECT-MPI) remains commonly used in the detection of myocardial ischemia. However coronary artery calcium scoring (CAC) is being increasingly used for assessment of stable coronary artery disease. Methods: A search was made of the PubMed, CENTRAL, EMBASE, CINAHL, EBSCO, and Web of Science databases for studies that compared SPECT- MPI with CAC, and reported detection rates of ischemia with SPECT-MPI. We derived a CAC score of <100 and >=400 as thresholds for detection of ischemia. A random effects model was used to pool sensitivity and specificity of CAC in the detection of ischemia. In addition, detection rates of ischemia with CAC were correlated with SPECT-MPI, and standardized receiver-operating curve (ROC) was drawn to compare CAC with SPECT-MPI. Results: 14 studies (N=6255) were detected which compared CAC scores and reported ischemia detected with SPECT-MPI. There was a strong correlation with ischemia detected with SPECT-MPI and CAC score >=400 (Spearman correlation coefficient: 0.609; p-value= 0.021). There was good specificity of CAC >=400 in detecting ischemia 74% (73%-75%) (ROC-AUC 0.76), however it did not have good sensitivity 55% (52%-58%). For a threshold of CAC <100, there was good sensitivity in ruling out ischemia 80% (77%-83%) (ROC-AUC 0.77), however detection threshold of CAC >100 did not have good specificity 66% (65%-67%). Conclusion: Thresholds of CAC of <100 and >=400 may effectively detect significant ischemia.
Transcript of Non Invasive ImagingNon Invasive Imaging A1050 JACC April 1, 2014 Volume 63, Issue 12 coronary...
Non Invasive Imaging
A1050JACC April 1, 2014
Volume 63, Issue 12
coronary arTery calciUM score of <100 effecTively rUles oUT presence of significanT ischeMia, while >=400 rUles in-insighT froM a MeTa-analysis of 14 sTUdies
Poster ContributionsHall CSaturday, March 29, 2014, 10:00 a.m.-10:45 a.m.
Session Title: Coronary and Cardiac CT: Improving DiagnosesAbstract Category: 18. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT AngiographyPresentation Number: 1104-63
Authors: Chirag Bavishi, Saurav Chatterjee, Edgar Argulian, Taimur Mirza, Alan Rozanski, St. Luke’s-Roosevelt Hospital Center, New York, USA
Background: Single photon emission myocardial perfusion imaging (SPECT-MPI) remains commonly used in the detection of myocardial ischemia. However coronary artery calcium scoring (CAC) is being increasingly used for assessment of stable coronary artery disease.
Methods: A search was made of the PubMed, CENTRAL, EMBASE, CINAHL, EBSCO, and Web of Science databases for studies that compared SPECT-MPI with CAC, and reported detection rates of ischemia with SPECT-MPI. We derived a CAC score of <100 and >=400 as thresholds for detection of ischemia. A random effects model was used to pool sensitivity and specificity of CAC in the detection of ischemia. In addition, detection rates of ischemia with CAC were correlated with SPECT-MPI, and standardized receiver-operating curve (ROC) was drawn to compare CAC with SPECT-MPI.
results: 14 studies (N=6255) were detected which compared CAC scores and reported ischemia detected with SPECT-MPI. There was a strong correlation with ischemia detected with SPECT-MPI and CAC score >=400 (Spearman correlation coefficient: 0.609; p-value= 0.021). There was good specificity of CAC >=400 in detecting ischemia 74% (73%-75%) (ROC-AUC 0.76), however it did not have good sensitivity 55% (52%-58%). For a threshold of CAC <100, there was good sensitivity in ruling out ischemia 80% (77%-83%) (ROC-AUC 0.77), however detection threshold of CAC >100 did not have good specificity 66% (65%-67%).
conclusion: Thresholds of CAC of <100 and >=400 may effectively detect significant ischemia.
